Evaluate breaches in the standard of care

Answer the following questions to find out if the standard of care was followed for your case.

With which of the following symptoms of dehydration did the patient present? (Choose all that apply)Fatigue/loss of appetiteHeat intolerance/increased thirstMuscle spasm/numb skinHeadache/ lightheadedness/clumsiness/delirium/lethargyAbsence of tears/sunken eyes/dim visionDry mouth/eyesBurning sensation in stomachDark urine/painful urination/less urinationDifficulty swallowingNone of the aboveNot elicitedAnswer unknownWhy is this important?Early symptoms of dehydration include headache, fatigue, loss of appetite, heat intolerance, light-headedness, dry mouth and eyes, burning sensation in the stomach and dark urine with a strong odor.(1999) 99 JNLADA 2 200-206

With which of the following risk factors did the patient present? (Choose all that apply) Why is this important?Answer this questionA risk factor is a variable that has a causal association with a disease or disease process; the presence of the variable in an individual or a population is associated with an increased risk of the presence or future development of the disease. Thus, risk factors may be useful for identifying subjects at increased risk for a disease or for a particular outcome that results from a disease process.Click here for additional information at ClinicalKey.com

Was a medical history obtained? Why is this important?Answer this questionA complete medical history and carefully focused physical examination serve as the core of the diagnostic process. The information obtained guides the further direction of the patient's examination, enables the clinician to make educated evaluations, and be better equipped to advise the patient.Click here for additional information at ClinicalKey.com

Was a medication history obtained? Why is this important?Answer this questionMedication regimen, especially diuretics; and nephrotoxic drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs), aminoglycosides, cisplatin, radiocontrast, and pentamidine can cause dehydration.Click here for additional information at ClinicalKey.com

With which of the following physical signs of dehydration did the patient present? (Choose all that apply) Why is this important?Answer this questionDehydration increases physiologic strain as measured by core temperature, heart rate, and perceived exertion responses during exercise heat stress. The greater the body water deficit, the greater the increase in physiologic strain for a given exercise task.Click here for additional information at ClinicalKey.com

Was a daily assessment for dehydration performed? Why is this important?Answer this questionHuman hydration assessment is a key component for prevention and proper treatment of fluid and electrolyte imbalances. Fluid balance monitoring needs to be performed daily.Click here for additional information at ClinicalKey.com

Which of the following diagnostic laboratory investigations were performed? (Choose all that apply) Why is this important?Answer this questionRoutine laboratory studies can provide important clues to diagnosis.Click here for additional information at ClinicalKey.com

Was a fluid intake/output chart maintained? Why is this important?Answer this questionWeight loss, malnutrition and dehydration can be detected at an early stage when a resident's intake and output is monitored closely. The intake and output must be documented and kept on the patient’s medical record.(2001) 2 JLAMDA 4 175-182

With which of the following type of dehydration was the patient diagnosed? Why is this important?Answer this questionClassification of dehydration as mild, moderate and severe is important for determining the rate of fluid replacement in the patient.(2008) 47 EARGER 3 340-355

Was gradual oral rehydration therapy performed? Why is this important?Answer this questionMild volume depletion can be treated by gradual oral rehydration or via a feeding tube.(2002) 3 JLAMDA 6 371-376

Were intravenous fluids administered? Why is this important?Answer this questionModerate volume depletion must be treated by more rapidly. Severe volume depletion should be treated rapidly via the intravenous route.(2002) 3 JLAMDA 6 371-376

Was the patient’s underlying cause of dehydration addressed? Why is this important?Answer this questionIt is necessary to identify the causes of an individual's fluid and electrolyte imbalance so treatment can begin.(2002) 3 JLAMDA 6 371-376

Which of the following were not monitored during rehydration therapy? (Choose all that apply) Why is this important?Answer this questionDuring fluid rehydration, the vitals of the patient and the urine output need to be closely monitored to assess signs of fluid overload.(2003) 32 EGASCN 4 1249-1267

On which of the following aspects of hydration therapy was the patient educated? (Choose all that apply) Why is this important?Answer this questionAlleviating dehydration should involve a combination of strategies that include assessment, education, and inclusion of practices that encourage fluid intake. Education is a vital component to help individuals maintain hydration before, during, and after activity. The factors of hydration program include diet, clothing, gender-based factors; age related blunting of thirst, exercise related education, increased caffeine use, alcohol consumption and situational factors.Click here for additional information at ClinicalKey.com

Was excessive hypertonic fluid administered to the patient? Why is this important?Answer this questionCommon causes of hypernatremia include excess hypertonic fluid administration: • Intravenous infusion of hypertonic fluid or excessive administration of intravenous normal saline with inadequate free water intake in hospitalized, critically ill patients • Total parenteral nutrition or enteral feedingsClick here for additional information at ClinicalKey.com

Was the patient monitored for diabetes insipidus? Why is this important?Answer this questionInadequate or inappropriate treatment of diabetes insipidus is a contributory factor for development of hypernatremia.Click here for additional information at ClinicalKey.com